Flying as an EMR?

Just to echo the previous point, in regards to scope of practice, the safest policy is "to do what only what you are currently trained to do" . If there is something that you think might be even slightly out of scope - or if you would normally ask for base contact - inform the flight attendant to get a patch to MedLink or the another ground physician service they subscribe to. Virtually all US airlines I've come across utilize a service like this. The ground physician can guide treatment and take responsibility for you to provide treatments. (For example, a Medlink MD might authorize a flight attendant to use an Epipen if it's equipped on board...an Epipen is actually optional equipment, the FAA only mandates 1:1000 epi ampoules to be carried, but that's another story...).

The sky is certainly not an excuse to provide cowboy medicine, even if the Good Samaritan protections afforded in the Aviation Medical Assistance Act is very generous.

Something to consider also is that the flight attendants may have another job...in healthcare. I've come across flight attendants who were ED nurses, retired physicians and paramedics/firefighters. In fact, JetBlue was featured in the news a couple months ago for specifically hiring retired NY firefighters, cops and medics, because of their emergency response background. If anyone of you see cabin crew doing their emergency drills in a cabin simulator, you'd be amazed how much they have to perform like we do when we do our NREMT skills.

Bottom line: if they need you, they'll call for you.

More info on the equipment and differences between "street" EMS and the kits and capabilities found on commercial passenger aircraft can be found in a fairly recent article on JEMS, here's the link:
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I happen to be the person that wrote that article, so if anyone has any particular questions, feel free to PM me and I'll try my best to answer any specific questions about the topic.
 
When I fly commercial, or fly as an FO on corporate and charter flights, I stick my chest out as far as possible and say, in my best US Army voice "I ... am a NC certificated Emergency Medical Technician Basic. Should an emergency arise while in flight, I will need to be notified immediately, and then everyone should stand back out of my way and let the professional handle it."

At that point people usually start rolling their eyes, especially the MDs and RNs, and walk off muttering to themselves. And my Captain will generally say something like "Shut the h@ll up and get the checklists ready!".

Doesn't bother me. I know in my heart that I am a BLS God.
 
Flight attendants 2 cents

I had to work on New years day (as a flight attendant). Sure enough on my last flight into Houston a guy goes down in the aisle. We do our usual "are there any doctors, nurses or other medical personel on board". Older guy walks up and says "I'm a doctor" I ask "what kind of doctor" the guy looks kinda embarrassed for a minute then says "gynecologist". I ask him if he could get the guys blood pressure while I talk to StatMD our online medical folks. He leans in and says "I haven't taken a manual blood pressure in over 15 years".
Again if you are an EMT let the Flight Attendants know. The first thing StatMD asks for is a blood pressure and they don't teach us how to take BP's, they should but they don't. Once someone goes down we sometimes get so involved we forget that we are supposed to page for medical assistance so don't be afraid to come tell us "I'm a paramedic or I'm an EMT". Before we let you do anything beyond taking a blood pressure we run your info by StatMD. We had one situation recently involving a cardiac arrest in which we had NO medical personel on board. StatMD tried to get one of the flight attendants to attempt an injection of some sort but none of them felt comfortable doing it. The flight attendants continued cpr through landing but the patient didn't make it. My understanding of the situation was that StatMD would have let anyone attempt that injection because at that point it was the guys only chance (AED detected no shockable rythm). But no one felt comfortable trying it even with a headset on and a doctor walking them through it. I know of a few situations in which scope of practice went out the window and StatMD (used to be medlink) allowed people to do something well beyond their training because the plane was 20 or 30 minutes out and there just wasn't anyone else. Anaphylaxis is a good example. I've heard of StatMD walking folks through the epipen.
 
bigbaldguy said:
As a 15 year light attendant and a brand new EMT my advice is this. Feel free to introduce yourself to the flight attendnt at the front of the plain. Over the years I've had doctors and nurses jump to the rescue on the plane and be of no use at all. I will take one decent paramedic over any 5 doctors. As Flight attendants we have a decent amount of training in handling the basic stuff but there is nothing that makes us hapier then when a paramedic steps in and saves the day. And jst a little FYI the o2 masks on the plane blow 2 liters on low and 4 on high
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Ok maybe I exagerated a bit about taking one paramedic over 5 doctors but seriously in my experience the usefullness of med personel on the plane is as follows from most helpful to least helpful

Paramedics
Nurse/Emt
Doctor

Yes I imagine upon occasion an ER doctor might happen to jump up and save the day but in my experience this hasn't been the case.
 
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bigbaldguy said:
Anaphylaxis is a good example. I've heard of StatMD walking folks through the epipen.
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Epipens are hardly an advanced medical device. "Press firmly into the outer thigh and under no circumstances put fingers over either side"

I think I would feel relatively comfortable with StatMD walking through code management on a plane. If they'd let me, i'd start an IV and give drugs. It would be fun, imho.
 
jjesusfreak01 said:
The problem with this is that even if you are held to national scope in the air, the second you hit the ground you no longer have a certification to do anything if you don't practice in that state, am I right?
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After revisiting this thread I realized that you would need to continue practicing in the scope that you were last utilizing, e.g. national standards in the air otherwise one may be looking at a potential case of patient abandonment. You can't simply stop working on a patient. Any thoughts on this?
 
Markhk said:
I happen to be the person that wrote that article, so if anyone has any particular questions, feel free to PM me and I'll try my best to answer any specific questions about the topic.
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Awesome article Mark! I found it rather informative and put together very professionally. There was obviously a reason that I remembered to refer back to it specifically months after reading it. Keep up the great work!
 
jjesusfreak01 said:
Sure, i'm maybe ok with that, maybe surgery or anesthesiology too, but you could have a psychiatrist, a gynecologist, or a pediatrician with absolutely no emergency experience besides a few weeks during their clinicals.
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Without getting into all the variables of the various experiences and fnctions of physicians, I would just like to point out that a gynecologist is a surgical discipline.
 
I've actually just come up with the perfect solution.

Every EMT (-B, -I, or -P) license or certification card should come with an RFID tag built in which broadcasts a signal identifying the presence of the provider. All public buildings and spaces shall be required to have receivers that will detect the presence of these tags. The receivers will be tied in to the phone system, so if anyone calls 911, the caller will be alerted that there is already an EMS provider nearby. The paging system in the building will automatically request the EMS provider to please present his or her self to a designated spot in the building, and the person who called 911 will have already been directed to go meet the provider at that spot so the caller can escort the provider to the scene of the emergency. Also, all cell phones will need an RFID receiver as well, so anyone calling 911 from a cell phone can also be alerted to the fact that there is an EMS provider nearby. Obviously, in places where calling 911 isn't really appropriate, other routines will need to be devised, such as what this thread is about, being on an airplane. For airplanes, the flight crew will have some kind of indicator light added to the instrument panel that indicates if an EMS provider RFID tag has been detected onboard, and if that light is on, in the event of an emergency the pilot only has to request that the EMS provider calls the flight attendant so he or she can take the provider to the patient needing help.

Obviously there are some further details to work out but I think this is a pretty good beginning... :D
 
jjr512 said:
i've actually just come up with the perfect solution.

Every emt (-b, -i, or -p) license or certification card should come with an rfid tag built in which broadcasts a signal identifying the presence of the provider. All public buildings and spaces shall be required to have receivers that will detect the presence of these tags. The receivers will be tied in to the phone system, so if anyone calls 911, the caller will be alerted that there is already an ems provider nearby. The paging system in the building will automatically request the ems provider to please present his or her self to a designated spot in the building, and the person who called 911 will have already been directed to go meet the provider at that spot so the caller can escort the provider to the scene of the emergency. Also, all cell phones will need an rfid receiver as well, so anyone calling 911 from a cell phone can also be alerted to the fact that there is an ems provider nearby. Obviously, in places where calling 911 isn't really appropriate, other routines will need to be devised, such as what this thread is about, being on an airplane. For airplanes, the flight crew will have some kind of indicator light added to the instrument panel that indicates if an ems provider rfid tag has been detected onboard, and if that light is on, in the event of an emergency the pilot only has to request that the ems provider calls the flight attendant so he or she can take the provider to the patient needing help.

Obviously there are some further details to work out but i think this is a pretty good beginning... :d
Click to expand...

roflmmfao!
 
JJR512 said:
Every EMT (-B, -I, or -P) license or certification card should come with an RFID tag built in which broadcasts a signal identifying the presence of the provider. All public buildings and spaces shall be required to have receivers that will detect the presence of these tags.
Click to expand...

ROTFL ... now you've done it, the government will start working on that and spend a bazillion of our tax dollars to make it a reality. Be careful what you think of/wish for :D
 
My ID already has an RFID tag to allow me station access, so we can work from there...

Flights are a possibility. They could simply have you register your medical certification when you buy your ticket, at which point the flight attendants would simply be able to look at the manifest to find the most appropriate provider/s, then tap them on the shoulder when they were needed.
 
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